Center for Opioid Epidemiology & Policy Research
Current research in NYU Langone’s Center for Opioid Epidemiology and Policy focuses on evaluating the impact that state policies and laws regulating the drug supply, access to naloxone, and access to treatment have on opioid overdose. To carry out this work, we have compiled state-level data on drug-related laws and policies, county- and zip code–level data on opioid treatment and harm reduction services, demographic characteristics, inpatient hospitalizations, and deaths. We also gather individual-level data on pharmaceutical industry marketing to physicians. The following are brief summaries of our current projects.
Epidemiology of Prescription Opioid Use
This project aims to understand how prescription opioid overdose is distributed across the country and to identify the population groups at highest risk. We are also working to understand the geographical patterns of opioid overdoses and to identify the types of social and economic features of local communities that affect opioid overdose rates.
Prescription Drug Monitoring Programs and Opioid Overdoses
This project uses an empirical approach (i.e., latent transition analysis) to identify the prescription drug monitoring program (PDMP) best practice models that are most effective at reducing prescription opioid overdoses and that minimize unintended consequences in illegally manufactured opioids. We are also examining whether there are sources of heterogeneous policy effects within states, notably focused on medical need for opioids, access to medication-assisted treatment, and socioeconomic characteristics in local (zip code level) areas.
Harm Reduction Laws and Opioid Overdoses
In this project, we examine the impact that naloxone access laws and overdose good Samaritan laws have on opioid overdoses. We look at the relationship between specific types of naloxone access and good Samaritan laws on specific types of opioid overdoses (prescription opioids, methadone, synthetics, and heroin). We also test whether the impact of harm reduction laws on overdose differs by the stage of the opioid overdose epidemic (for example, before and after the escalation of heroin and synthetic opioid overdoses). In addition, we examine whether the impact of state-level harm reduction laws on overdose depends on local access to overdose education and naloxone delivery services.
Access to Treatment and Opioid Overdoses
We have two types of projects underway related to treatment. First, we are examining the impact Medicaid expansion has on opioid overdose rates. Although prior research suggests that Medicaid expansion has led to increased local access to medication-assisted treatment for opioid dependence, no previous study has examined whether expanded Medicaid coverage has had an impact on overdose rates. Second, we are tracking the geographic distribution of opioid use disorder treatment services across the country, to investigate whether disparities in access to buprenorphine versus methadone vary according to the racial and ethnic composition of communities. We are also researching the extent to which opioid use disorder treatment services provide access to medication-assisted treatment, and where there are gaps in access to these treatment services across the United States.
Marijuana Legalization and Opioid Overdoses
In this project, we examine how marijuana legalization affects the opioid overdose epidemic. Building on our prior work on marijuana legalization and changes in substance use in the United States and Latin America, we aim to understand the extent to which marijuana legalization could plausibly lead to substitution of opioid use for marijuana use; whether the impact of marijuana legalization on opioid use, abuse, and overdose depends on the type of legalization model adopted (restricted versus expanded access to medical marijuana or recreational marijuana legalization); and how expanded legal access to marijuana modifies the impact of opioid supply restrictions on opioid use, abuse, and overdose.
Pharmaceutical Industry Marketing and Prescribing Practices
This project is an examination of how the pharmaceutical industry has contributed to changes in prescribing practices and opioid overdoses in recent years. We first examined the impact of pharmaceutical industry marketing on prescribing in the Medicare population and saw that physicians who received payments (even small ones, such as a meal) increased opioid claims from one year to the next, whereas physicians who did not receive any payments saw a decrease in opioid claims over time. We then examined this problem in the general population and saw that in counties where there was an increase in payments to physicians for opioids, there was also an increase in the opioid-prescribing rate and an increase in opioid overdose rates.
Synergistic Effects of Cannabis and Prescription Opioid Policies on Chronic Pain, Opioid Prescribing, and Opioid Overdoses
This study leverages data from the Medicaid Analytic eXtract and from the National Survey on Drug Use and Health to examine the independent and joint effects of cannabis legalization and prescription opioid policies on opioid use and misuse, opioid use disorder, opioid prescribing, clinic visits for chronic pain, and opioid overdoses.